55 N 8th St, Apt #1, Lewisburg, PA 17837

Rental Application

Separate application required from each applicant age 18 or over.

Personal Information

Additional Occupants

List everyone, including children, who will live with you.

Occupant 1

Occupant 2

Occupant 3

Occupant 4

Rental History




Have you ever:

References & Emergency Contacts

Reference 1

Reference 2

Reference 3

Reference 4

By submitting this application, I certify that all information given above is true and correct and understand that my lease or rental agreement may be terminated if I have made any false or incomplete statement in this application. I authorize verification of the information provided in this application from my credit sources, current and previous landlords and employers, and personal references.